SALT LAKE CITY — Tommy Tanzer spent years expecting a cancer diagnosis, but simple blood results never delivered such news, thus delaying necessary treatment.
"We won't treat a patient unless we have a pathologic diagnosis," said Dr. Jonathan Tward, a radiation oncologist at the Huntsman Cancer Institute. "We just thought we were watching it grow in a patient when we could be treating it."
Tanzer, 67, had endured three prostate biopsies that all came back negative for cancer, but also had an increasing prostate-specific antigen concentration in his blood, which may or may not be an indication of cancer in the prostate.
"I was virtually certain Mr. Tanzer had prostate cancer," Tward, who has decades of experience treating prostate cancer, said. Both the doctor and patient were becoming frustrated.
"It is possible that Mr. Tanzer's life was being jeopardized by delaying treatment because of the inefficiencies of diagnosis," he said.
Then, new technology using magnetic resonance imaging (MRI) came along about a year ago at the Huntsman Cancer Institute — the first of its kind in the region — providing new hope for a diagnosis for Tanzer and for others undergoing repeated biopsies.
The MRI-guided prostate biopsy procedure, which lasts about 30 minutes under conscious sedation, has since led at least 50 men to better results and more targeted treatment.
Whereas a typical biopsy involves 12 to 14 needles blindly placed in different parts of the small walnut-shaped gland located in the pelvis, an MRI-guided prostate biopsy can be more specific, requiring as few as one or two needles that extract a small amount of tissue directly from a supposed cancerous lesion within the prostate.
"No other type of cancer diagnosis is as random," said Huntsman radiologist Dr. Rulon Hardman. "Imagine sticking that many needles into each breast to find breast cancer. It just wouldn't be done."
"Some of these men have had three, four, five, six biopsies over the years and they've all been negative, but then they have this procedure and we find cancer," Hardman told the University of Utah Department of Radiology and Imaging Sciences. "You can just imagine how much discomfort they've been in and their relief over finally having a definitive diagnosis."
The relatively new procedure, he said, not only reduces the number of repeated biopsies, which are spread out over several years, but nets greater accuracy in diagnoses leading to earlier detection and treatment and longer life expectancies.
Tward said it also results in fewer complications.
"Every time you stick a needle into the prostate, you run the risk that the person might end up with sexual dysfunction, urinary dysfunction or bowel dysfunction," he said, adding that repeated biopsies, although common over time, are not only unnecessary, but are costly.
Tanzer said the preparation for repeated biopsies over the years "was more invasive than anything they did (with the MRI)."
"It was nothing," he said. "They found it right away."
Then, a week ago, Tanzer endured a minimally invasive procedure in which radioactive seed implants, brachytherapy, were placed directly into his prostate to treat the cancer. Tward expects it's the only treatment his patient will need aside from semiannual appointments for a couple of years to check bloodwork.
And it came without inflicting damage to other parts of Tanzer's body, which would've been a concern with the commonly used widespread radioactive treatment of prostate cancer.
"I never had to worry," Tanzer, of Park City, said Friday. "The assurance these people (at Huntsman) make you feel they make you feel that you're doing the right thing. They treat you with dignity, and that makes you feel so good."
Typical radiation treatment for Tanzer's cancer would have included five treatments a week for eight weeks, he said.
The former Major League Baseball agent has already flown out of Utah twice since his procedure last week and is planning a lengthy trip to Hawaii in the coming week, which he said is evidence of how good he feels.1 comment on this story
"He has an amazing life expectancy and his quality of life has been preserved," Tward said of Tanzer, adding that he's "95 percent sure" that Tanzer won't have prostate cancer creep up on him again.
"We altered the fate and the quality of life and the ability to function and the ability to work and the ability to have normal intimate relations with their wife, the ability to pee normally, the ability to have normal bowel movements, the ability to not suffer, the ability to not take painkillers, the ability to do all the things people want to do," he said.
"All those things can suffer if you have to deal with an uncured prostate cancer."